Input Form for Registration
1) Type of the Document: ( Tick Mark ‘√’ against appropriate)
Conveyance Deed Partnership (1), (2), (3)
Exchange of property Settlement
Gift Power of attorney with consideration
Certificate of Sale Transfer of Lease by way of assignment
Partition Agreement of Sale (with possession)
Further Charge Mortgage Deed (with/without √
possession
Lease Any Other
2) Presenter of Document: ( Tick Mark ‘√’ against appropriate)
Transferee/ Claimant
Transferor/ Executant √
Power of Attorney
3) Details of the Presenter of Document:
Name Yash
Name of Father/Husband Ganpat
Surname Dhuri
Address
4) Transferee/ Purchaser:
Name ADITYA BIRLA FINANCE LTD.
Name of father/Husband
Surname
Age
Residential Address Surat
Contact Number
PAN Number
Email Address Occ.
5) Transferor/ Seller:
Name Yash
Name of father/Husband Ganpat
Surname Dhrui
Age
Residential Address
PAN Number
Email Address Occ.
6) Confirming Party / Guarantor:
Name
Name of Father/Husband
Surname
Age
Residential Address
Contact Number
PAN Number
Email Address
1|Page
7) Name of the Witness (First)/ Identified by:
Name
Name of Father/Husband
Surname
Age
Residential Address
Contact Number
Witness 1._______________
(Signature)
Name of the Witness (Two):
Name
Name of Father/Husband
Surname
Age
Residential Address
Contact Number
Witness 2. _____________
(Signature)
8) Stamp Duty Payment Date: Day Month Year
01 2022
9) Date of signing Document: Day Month Year
01 2022
10)Total Number of pages in the Document:
11) Location Details
Name of District Kutch
Name of Taluka Anjar
Name of Village Modvadar
12)Details of the Property:
Tikka/Sheet No./C.T.S No.
T.P No. / Final Plot No.
Revenue Survey No./Block No. Revenue Survey No. 200
Zone Number
Rate per Sq. Mt.
13)Full description of property as written in the Document: -
Flat No
Shop
Office No
Floor
Name of Building
Nearest Land Mark
Other Details
2|Page
14)City / Town:
Property Type Tick Property Type Tick
Mark Mark
Residential Constructed (Open + Constructed)
Non-Residential Agricultural Land
Open Any Other (Specify)
15)Village:
Property Type Tick Property Type Tick
Mark Mark
Residential Constructed (Open + Constructed)
Non-Residential Agricultural Land
Open Any Other (Specify)
16)Area of Property:
(Write the Area in Sq. Mt.)
Use of Type of Construction Total Built-up Plot
property Area Area
A. Residential Flat / Apartment
Tenement
Row house
Bungalows
B. Commercial Shop: Carpet Area
in Sq. Mt.
Tick Mark on the Facing Main
appropriate Road
Not on main
road
Ground Floor
First Floor
Basement
Mezzanine
Office( Carpet Area
in sq. mt.)
C. Industries Factory Shed:
Built-up Area in sq. mt
Plot Area in sq. mt.
D. Agriculture Open land (farm): Total plot area in sq
mt
E. Non- Open land: Total plot area in sq mt
Agriculture
(Open Land)
17)Type of property: (Tick mark on the appropriate)
Residential Bank/ Nursing Home/ Coaching Class/
Gymnasium/ Library
Office Clinic
Shop Agriculture
Industrial Non-Agriculture
Any Other
(Specify)
3|Page
18)Type of Construction and Other Amenities:
R.C.C.Frame structure/ Apartments (sq. mt)
Space (sq. mt)
Load Bearing structure (sq. mt)
Semi Kaccha Construction (With RCC Slab) space
(sq. mt)
Industrial structure
Other Amenities
Parking (sq. mt)
Terrace
Open Space (sq. mt)
19)Details on Construction:
Total number of Floor ( Ground+)
Year of Construction
Level of Construction
20)Other Details:
Market Value Rs.( if derived from Valuer)
Loan Rs.
Consideration Rs.
Stamp Duty Paid Rs.
21)List of the Document Attached: ( Tick mark against the appropriate)
Latest Property Card/ 7/12 Sanctioned Building Plan & B U
Permission by Competent Authority
Layout plan/Key Plan Sanctioned Order of Competent
(Digitized Map, if available Authority for purchase of
Agriculture Land for non-
Agriculture purpose
------------------------------------------------------------------------------------------------------------
Information given above is Complete, Proper and True. According to this I am ready
to pay Stamp duty and Registration fees.
1) Transferee Signature
2) Transferor Signature
---------------------------------------------------------------------------------------------------------------
For Office Use (This form should be filled in Gujarati only)
Name of Sub-Registrar Office …………………………………………………..
Token No. …………………………………………………………….………….
Article No ………………………………………………………………………..
Document No./ Date ……………………………………………………………....
For Office Use Only
Information given in Extract before registration and document is absolutely same.
Data Entry has been done accurately as mentioned in the Input Form
Signature of clerk
Signature of Data Entry Operator
Signature of Sub-Registrar
4|Page
